Chronic kidney disease can progress silently, making testing essential

Chronic kidney disease often advances quietly, and a normal blood creatinine result does not always mean that kidney function is intact. Dr. Trịnh Hùng of the Nephrology and Rheumatology Department at 19-8 Hospital said the disease affects about 10% of people worldwide and in Vietnam.

Many people focus only on their creatinine level when they undergo testing. But creatinine can remain within the normal range while kidney function has already begun to decline, particularly in older people or those with low muscle mass. Dr. Hùng said doctors should therefore assess several indicators instead of relying on a single result.

One key measure is estimated glomerular filtration rate, or eGFR. Calculated from blood creatinine together with age and sex, eGFR reflects how effectively the kidneys filter waste each minute. It also helps doctors assess the degree of decline and classify chronic kidney disease into five stages, each with different monitoring and treatment goals.

The urine albumin-to-creatinine ratio, or uACR, is another important test that often receives less attention. Albumin normally stays in the bloodstream, but damage to the kidney's filtering membrane can allow it to enter the urine. uACR can identify this damage before eGFR falls, making it an early warning tool.

A routine urinalysis is simple and inexpensive but can provide additional information by detecting red or white blood cells, albumin, protein and glucose. These findings may point to conditions including glomerulonephritis, urinary tract infection or tubular damage. Blood and urine tests assess function, while a kidney ultrasound examines shape and structure. It can reveal stones, cysts, obstruction causing urine retention, tumors or kidneys that have become small because of chronic disease.

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The kidneys are like the body's water treatment plant.